A Consciously Chosen Death in the Netherlands

By Donella Meadows

–May 21, 1998–

There are topics — abortion, guns, property rights — that Americans can’t discuss without high emotion and polarization. But other nations seem to have no trouble with them. Why is that?

I’m no psychologist, but I’d guess it’s because these subjects bring up enormous fears we are unwilling to face. In the case of one such subject, euthanasia, the source of the fear is obvious. We don’t want to look at, discuss, choose or even think about death.

Denial doesn’t work, of course. Whatever we suppress just roots itself more deeply in our subterranean terror. Our minds fill with fantasies — greedy relatives with a needle, Kervorkian in a van — which further fuel our emotions.

I think the societies that can handle these issues are willing to take a square, unblinking look at them. They dwell in reality, which is never so scary as our fears.

In that spirit, I offer here a description of an act of euthanasia, carried out in Holland, where the practice is legal and tightly regulated. My friend Wouter Biesiot recently died after a long struggle with cancer. The following was written by his wife Nanda, who has given me permission to share it with you.

* * *

“The pain became worse, despite increasing amounts of morphine. It was no pain that could be located precisely. It was more a strong physical suffering all over his body. He was spending a lot of energy trying to find good moments in every day. And he found them. There weren’t many sunbeams, but every sunbeam he felt. He could laugh at the girls and tell them they were wonderful and he was proud of them. But the suffering increased. It was such hard work, it hurt me so much to see Wouter in pain and to accept that I could not do any more than I did.

“Then the day came when Wouter felt he couldn’t do it any longer. It was on a Thursday night when he, our neighbors (Henk and Neske), Janna and I were sitting together. Wouter asked Henk to pray about letting go. On Friday afternoon, Henk and Wouter talked and Wouter was clear about his wish to die. Henk summed up their conversation: inside there are two voices. One of them tells you to live and the other to die. The second one becomes stronger, but the other is still there. Only when the two voices are telling you the same thing, then it is your time.

“We had discussed euthanasia, because we thought it was important to prepare ourselves for unknown situations. We never thought Wouter would be the one to make the decision. We thought I would be the one to decide.

“Now Wouter really wanted to let go. But he could not. His heart and lungs were just too strong. Just a year ago, before his liver operation, he could skate the ‘eleven-cities-tour!’ Only last December he stopped going to the fitness center! That strong physical condition was now working against him in his dying.

“The weekend was very tough. He tried being with us, but he couldn’t. The chat of the girls was too much for him. We sat with him, watching him sleep. Even in those last days, he got up to wash, to eat bread with strawberries. It took everything he had, but he did it. Not doing so would be the same as being dead for him. Until the last moment he stayed in control.

“On Monday Wouter said he was ready. The two voices were saying the same thing. But it took a whole day before the moment was there. As opposed to the days before, Wouter didn’t sleep at all. He was alert, and that made the day long and tough. And I won’t even talk about the legal procedure!

“The doctor said he would come after 7 pm. The girls and Henk and Neske and I sat with Wouter, waiting. Marijn had made a drawing of Winnie the Pooh. She showed it to Wouter and he smiled at her. Even at that moment, you could see how proud he was of his youngest. Finally the doctor arrived. He first talked to Wouter and me, then to the girls. After that he left us alone for the time we needed. Henk (who is a priest) spoke a prayer and gave Wouter the blessing. Wouter was so very ready for that. We all gave him a hug. There were no words of farewell, because he would stay with us.

“Then Wouter said to Henk, ‘go in peace.’ Everyone left except me, and the doctor gave him something to drink. In my arms, Wouter fell into a coma. The others came to be with him, except for Marijn, who was frightened, so she left with Neske. He died at 8.45 pm. It was not real and so very real at the same time. We were relieved that at last his suffering had ended. And that we all were there when he died in his own home.

“Guided by the female undertaker, Janna, Hester and I washed him, rubbed him with nice smelling oil and put on his wedding clothes. That was a wonderful thing to do. It felt so good. Marijn had a quick look at Wouter. She wasn’t frightened anymore, but she was very clear in not wanting to join us. The undertaker carefully watched us and asked what we wanted to do. I was so happy with her, because everything that happened from that time on happened because we wanted it to happen.

“The girls and I made Wouter a lovely room in the house, with candles, lots of yellow sunflowers, dear pictures and beautiful stones. I so much felt him there, his soul filled the whole room. It was wonderful that we could walk in and out at moments we chose. We also could see him become more and more dead and that made me grow ready for the moment of letting him go out of the house to his ceremony in the church on Friday.

“We had chosen a small cemetery at the northern part of Groningen. When we arrived, the sun was shining. A goose was flying over, making a lot of noise. We could hear frogs. It was raining pink blossom from two beautiful trees. The grass was filled with daisies and dandelions. We brought Wouter to his grave and we took our time there. All this made it a lot easier for me to leave Wouter, comforted by the warmth of the sun, the flowers and so many dear friends.”

* * *

I can come to all sorts of judgments about euthanasia in general, in theory, unrelated to a real person’s life and pain and death. I can see that euthanasia misused, unregulated, carried out without love or mindfulness, could be a horrible thing. Wouter and Nanda have shown me that euthanasia in the hands of a civilized society and people who accept and honor the fact of death can be beautiful. I don’t know whether I would choose such a death for myself. I don’t think I could know that until the moment actually came. I can’t imagine having the knowledge, the certainty, or the right to prescribe it or forbid it to others. I would not want others to prescribe it or forbid it to me.

multimedia

Quotations

About The Donella Meadows Project

The mission of the Donella Meadows Project is to preserve Donella (Dana) H. Meadows’s legacy as an inspiring leader, scholar, writer, and teacher; to manage the intellectual property rights related to Dana’s published work; to provide and maintain a comprehensive and easily accessible archive of her work online, including articles, columns, and letters; to develop new resources and programs that apply her ideas to current issues and make them available to an ever-larger network of students, practitioners, and leaders in social change. Read More

Newsletter Sign Up

The Academy occasionally sends E-newsletters with updates on the work of our fellows, the Donella Meadows Project and more. Sign up here if you'd like to stay connected.